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Efficacy of the internal mammary artery in combined aortic valve replacement-coronary artery bypass grafting.

Publication ,  Journal Article
Gall, S; Lowe, JE; Wolfe, WG; Oldham, HN; Van Trigt, P; Glower, DD
Published in: Ann Thorac Surg
February 2000

BACKGROUND: While internal mammary artery (IMA) use predicts improved survival after coronary bypass grafting (CABG), it remains unknown whether patients undergoing concomitant aortic valve replacement (AVR) realize a similar benefit. METHODS: All patients at a single teaching institution, undergoing combined AVR-CABG, which included a graft to the left anterior descending coronary artery (LAD) from 1984 to 1994 (n = 227) were examined retrospectively. RESULTS: Patients receiving an IMA graft (yesIMA, n = 135) and patients receiving only saphenous vein grafts (nonIMA, n = 92) were not different in their presenting symptoms, or in their incidence of preoperative risk factors. The patients with IMA were more likely to be male, have a later year of operation, be younger, and have a greater body surface. Morbidity was not different between groups. IMA use did not affect 30-day mortality. Long-term actuarial survival was greater in the group with IMA (63% +/- 7% vs 42% +/- 6% at 5 years, p < 0.01). A multivariate Cox proportional hazards model demonstrated that use of an IMA graft improved survival, while recent myocardial infarction, diabetes, earlier year of operation, and lower ejection fraction diminished long-term survival. The relative risk of IMA grafting was 0.570. CONCLUSIONS: Within the limits of a retrospective analysis, patients in a modern era of cardiac operation, who undergo combined AVR-CABG, do not suffer increased morbidity from IMA use, and may realize a survival benefit from use of the IMA as a conduit for bypass of the LAD coronary artery.

Duke Scholars

Published In

Ann Thorac Surg

DOI

ISSN

0003-4975

Publication Date

February 2000

Volume

69

Issue

2

Start / End Page

524 / 530

Location

Netherlands

Related Subject Headings

  • Retrospective Studies
  • Respiratory System
  • Proportional Hazards Models
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Internal Mammary-Coronary Artery Anastomosis
  • Humans
  • Heart Valve Diseases
  • Female
 

Citation

APA
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ICMJE
MLA
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Gall, S., Lowe, J. E., Wolfe, W. G., Oldham, H. N., Van Trigt, P., & Glower, D. D. (2000). Efficacy of the internal mammary artery in combined aortic valve replacement-coronary artery bypass grafting. Ann Thorac Surg, 69(2), 524–530. https://doi.org/10.1016/s0003-4975(99)01399-5
Gall, S., J. E. Lowe, W. G. Wolfe, H. N. Oldham, P. Van Trigt, and D. D. Glower. “Efficacy of the internal mammary artery in combined aortic valve replacement-coronary artery bypass grafting.Ann Thorac Surg 69, no. 2 (February 2000): 524–30. https://doi.org/10.1016/s0003-4975(99)01399-5.
Gall S, Lowe JE, Wolfe WG, Oldham HN, Van Trigt P, Glower DD. Efficacy of the internal mammary artery in combined aortic valve replacement-coronary artery bypass grafting. Ann Thorac Surg. 2000 Feb;69(2):524–30.
Gall, S., et al. “Efficacy of the internal mammary artery in combined aortic valve replacement-coronary artery bypass grafting.Ann Thorac Surg, vol. 69, no. 2, Feb. 2000, pp. 524–30. Pubmed, doi:10.1016/s0003-4975(99)01399-5.
Gall S, Lowe JE, Wolfe WG, Oldham HN, Van Trigt P, Glower DD. Efficacy of the internal mammary artery in combined aortic valve replacement-coronary artery bypass grafting. Ann Thorac Surg. 2000 Feb;69(2):524–530.
Journal cover image

Published In

Ann Thorac Surg

DOI

ISSN

0003-4975

Publication Date

February 2000

Volume

69

Issue

2

Start / End Page

524 / 530

Location

Netherlands

Related Subject Headings

  • Retrospective Studies
  • Respiratory System
  • Proportional Hazards Models
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Internal Mammary-Coronary Artery Anastomosis
  • Humans
  • Heart Valve Diseases
  • Female